This is one of the most popular queries on search engines, but the results do not always provide useful information to readers. This article was written in order to get a clear understanding of panic attacks, the reasons for their occurrence and ways in which you can cope with them. We will consider the questions: What is a panic attack? What are the physiological features of a panic attack? What “cockroaches” can be associated with panic attack? Procedure for dealing with a panic attack. Your anxiety may be pushing you to skip straight to the last point of the article, but I recommend that you read it first, because without understanding the nature of a panic attack, you will probably have a very difficult time dealing with it cope.What is a panic attack? Panic attacks are quite common and are experienced not only by people with anxiety disorders, but also by healthy people. Typically, a panic attack is experienced as an acute, “ten out of ten” anxiety attack, accompanied by palpitations, dizziness, difficulty breathing, and possible sensations of heat, tingling in the body, nausea, weakness, unreality of what is happening, etc. The peculiarity of a panic attack is that that she, most often, comes suddenly and thereby creates the effect of a “sudden guest” - you don’t know when he will arrive next time, and therefore you try to always be ready for his arrival. This state of readiness, or vigilance, increases the overall tension and level of anxiety, which increases the likelihood of the next PA. At the same time, at the level of thinking, a very “loud” belief appears that something bad will certainly happen, in which at the moment of PA a person believes 100% At the level of behavior, this belief most often leads to the so-called safe, or “insurance” behavior: lean on the wall, sit down, go home, or not leave the house at all. Is it possible to “go crazy” from panic attacks? No, panic attacks do not do not lead to any serious disturbances either physically or psychologically. You cannot die from panic attacks, they are not associated with schizophrenia, and do not pose a risk of harming yourself or others. At the same time, panic attacks are a common symptom of various anxiety disorders: agoraphobia, panic disorder, somatomorphic disorder, health anxiety (“ hypochondria”), irritable bowel syndrome, etc. In general, a panic attack in itself is a private symptom (like fever), and not a disorder, and only a clinical psychologist, psychotherapist or psychiatrist can assess the patient’s condition, based on the clinical picture as a whole In this regard, if panic attacks bother you for two weeks or more, please consult a psychologist or psychotherapist. The internationally recommended method of treating anxiety disorders is cognitive behavioral therapy. What are the physiological characteristics of a panic attack? I spoke in detail about the neurophysiological mechanisms of the anxiety response in this article. If we summarize the data, we can say that the amygdala, a subcortical brain structure that reacts like an alarm in situations of threat and security violation, is responsible for “triggering” a panic attack. In people suffering from panic attacks, this alarm, for various reasons, becomes hypersensitive and goes off in the same way as some car alarms - from a gust of wind or loud sounds of fireworks. At the same time, the amygdala triggers a chain of physiological reactions, accompanied by a sharp release of corticosteroids into the blood and general mobilization of the body (the amygdala is a very ancient brain structure, and our “young” cerebral cortex cannot always cope with it). So, in the absence of a real tiger, we react as if the tiger is hunting us, and we urgently need to escape - and for this we need adrenaline, more air and blood in the muscles. Accordingly, the perception of the situation also corresponds to the perceptiona real “tiger”, because precisely when faced with mortal danger, the thoughts “I’m going to die” and a readiness to escape would be appropriate. In this case, hyperventilation and shallow breathing play a huge role (I wrote about this in detail here). Hyperventilation causes an imbalance of O2 and CO2 in the blood, which leads to dizziness, palpitations and a feeling of derealization, which a person mistakes for symptoms of a panic attack, which further aggravates the situation. Do an experiment at home: try breathing deeply and quickly for a minute, and you will see that in a situation of complete safety you will experience sensations similar to a panic attack. What “cockroaches” can be associated with a panic attack? Despite the fact that a panic attack itself may not be associated with certain circumstances or thoughts, in In my practice, I have observed several patterns characteristic of panic states. These patterns represent a tendency to interpret a situation in a certain way, as well as certain beliefs that a person strongly believes in. Catastrophic thinking is a common cognitive distortion in which any uncertainty in life is interpreted in a catastrophic way: “if I’m late for work, I’ll get fired.” , “if I have a headache for the second day in a row, it means I have cancer,” “if I have a panic attack, I will die,” etc. It is not surprising that these thoughts are followed by “insurance” behavior. This is also connected to the second cognitive distortion - “black and white thinking”, which implies that a person considers only extreme options: either “getting cancer” or “being absolutely healthy”; or “they’ll fire you” or “they won’t notice anything,” etc. Intermediate options (such as pain as a result of increased blood pressure or reprimand from management for being late) are usually not considered. Also, rules or shoulds are often connected to cognitive distortions: “I must be strong”, “I need to keep the situation under control”, “ You can’t relax.” And the more a person believes in these rules, the more tension and stress they create. Behind the rules, in turn, are deeper beliefs - about themselves, about the world around them, about their future (for example, “I am helpless”, “from me everyone turn away”, “the world is unsafe”). These beliefs are often not recognized by the person, and on a conscious level he avoids everything connected with them. So what to do about it? Procedure for PA When I ask my clients what will happen if you do nothing about a panic attack, most of them replies that panic will increase. At the same time, the hyperventilation experiment shows that there is a certain maximum point, after which anxiety begins to decrease. Moreover, “insurance” behavior dramatically reduces anxiety, as a result of which the illusion of an easy way to control the situation is created. At the same time, this deprives a person of the opportunity to meet anxiety face to face and withstand its “gaze.” In the figure, the level of anxiety during “insurance” behavior is indicated by a red line (“avoidance” - avoidance). An alternative behavioral strategy is to realize your anxiety and simply wait it out. At the same time, it is extremely important to normalize your breathing, since at the beginning of a panic attack hyperventilation always occurs, which intensifies the symptoms of anxiety. In the figure, the level of anxiety for this behavior is indicated by a blue line with the caption “exposure” (exposure - presentation). In summary, the algorithm of actions during a panic attack: Normalization of breathing. Breathe the way you breathe in normal life. You can also exhale a little longer than inhale. Decatastrophizing the situation. Instead of thinking that something bad is going to happen, remind yourself that after some time the panic attack will pass, and you can just wait until the anxiety subsides (and this will definitely happen). Observer position. Observe your anxiety levels and body sensations as if they were near you, not inside you. Just.